A mobile health initiative now being expanded across numerous rural clinics in South Africa’s Eastern Cape Province underlines the positive impact mobile can have on healthcare.
The initiative, the Mobile Health Information System (MHIS), is a collaborative effort that uses mobile technology to support the work of rural health professionals. The pilot project was rolled out in two phases, and now provides health workers in community health centres, tertiary and district hospitalswith an Internet-capable, commercially available smart phone pre-loaded with a locally-relevant, reliable clinical library containing about 4,000 pages of content. The Mobile Health Library includes South African treatment guidelines, drug formularies, diagnostic tools, and other evidence-based content. Information is downloaded using 3G connectivity from the ECDOH mobile library portal to mobile devices.
Nurses and doctors in three hospital complexes – East London, Mthatha and Port Elizabeth, five district hospitals and ten rural community health centres are already using the MHIS for accessing clinical and public health information at the point of care, and the programme is expected to be significantly expanded across the province over the next two years.
Nurses and doctors using the content report that it helps them to deliver improved patient care.
Sabisile Xokweni, a nurse at Ncora Clinic, says: “I work on ante natal care, but when I make physical diagnosis, patients with other conditions such as herpes zoster come. I find information from the mobile phone about managing such conditions.”
Khuluma Mnanzwa, a nurse at Port St. John Clinic, adds: “It has been very useful to have all the management guidelines on one device. It is very easy to carry around with all the information in one form. Usually I would only carry one reference book with me relating to the department I am currently working in, however with all the books easily accessible I am able to cross reference easily and find information I would not usually have access to. The internet access has also been useful when looking up information relating to patient care.”
And Dr. Natasha Hugo at the Port Elizabeth Hospital Complex, says: “The books in the mobile library are really helpful to make diagnosis and for quick check of the drugs guidelines, very handy and comfy to use. I must say that I am impressed with this technology having all the information I need to manage my patients on my palms is amazing. It will be nice for all the doctors at district levels to have access to the tablets, Kudos to ECDOH.”
The FHI 360 TechLab, supported by grants from Qualcomm Wireless Reach initiative, and the Henry E. Niles Foundation, designed, planned, and implemented the MHIS project, in collaboration with partner organisations including the Eastern Cape Department of Health, the Port Elizabeth Hospital Complex, MTN-South Africa, Nelson Mandela Metropolitan University, and the funders.
Kyle Moss, Government Affairs Analyst for Qualcomm’s Wireless Reach initiative, says the project underlines the major role mobile can play in improving healthcare. “Wireless Reach is excited the potential mobile has to improve people’s lives, she says, so a significant proportion of our projects have a health focus.”
In another health-focused initiative, Wireless Reach works with Telkom Kenya, the Communications Commission of Kenya, Dell, RTI International and the Nairobi Provincial Medical Office to reduce the administrative burden on health care workers and improve
patient care by strengthening pharmaceutical management systems for ART utilising 3G technology. The system allows clinics in and around Nairobi to track ARV stock and patient regimens, generate reports and maintain treatment guidelines.
While mobile technology can significantly improve healthcare, it is important to note that one-size-fits-all solutions are not the answer, says Moss. “It is important to first understand the culture and unique challenges of the environment. The partners are also key to the success of any Wireless Reach programme,” she says.
Because the partners will support and ultimately take over responsibility for the running of any programme, they have to be included in all planning, and training and sustainability has to be built in to the project from the outset, says Moss.
The South African project has now been handed over to the Eastern Cape Department of Health. Its success to date has been measurable. A research study on the impact of the MHIS on project participants conducted by Nelson Mandela Metropolitan University/School of Clinical Care Sciences found that being able to access health information at the point of care assisted:
° All nurses and approximately 85 percent of doctors in making an accurate diagnosis
° All nurses and more than 92 percent of doctors in prescribing the correct treatment for their patients
° 96 percent of nurses and approximately 82 percent of doctors in prescribing the correct medication dosage
° All nurses and approximately 81 percent of doctors in reducing patient mortality
• Nurses and doctors used information in the mobile library to empower patients, provide correct and up-to-date information to patients regarding their health conditions and treatment, update their own knowledge regarding the management and treatment of various conditions and provide colleagues and peers with correct information upon request.